Individual
MRS. CHRISTIE ELIZABETH WANDERER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 444-6000
Mailing address
75 MIDWAY ST, BABYLON, NY 11702-4311
(631) 793-8798
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
346430
NY
Other
Enumeration date
04/02/2021
Last updated
04/02/2021
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